Article (Scientific journals)
Dissociation between 2-[(18)F]fluoro-2-deoxy-D-glucose positron emission computed tomography, ultrasound and clinical assessments in patients with non-severe rheumatoid arthritis, including remission.
Rinkin, Charline; Fosse, Pacôme; MALAISE, Olivier et al.
2021In BMC Rheumatology, 5 (1), p. 31
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Keywords :
Positron emission tomography (PET); Remission; Rheumatoid arthritis (RA); Ultrasonography (US)
Abstract :
[en] BACKGROUND: Inflammation of patients joints with severe disease activity of rheumatoid arthritis (RA) has already been visualized and quantified by 2-[(18)F]fluoro-2-deoxy-D-glucose positron emission computed tomography ([(18)F] FDG PET/CT), but little is known about the metabolic status and its relationship with clinical and ultrasonography (US) metrology in patients with low/moderate activity or in remission. METHODS: Clinical assessments [based on 28-joint disease activity score (DAS(28)-CRP) and Clinical Disease Activity Index (CDAI)], [(18)F] FDG PET/CT, US and X-ray were performed on 63 RA patients classified into remission or low/moderate or severe disease activity groups. PET/CT was visually and then semi-quantitatively analysed by determining the standardized uptake value (SUV) of positive joints. RESULTS: Of the 1764 joints, 21.1% were tender only, 13.7% swollen only, 27.6% tender or swollen, 7.3% tender and swollen, 20.5% PET/CT-positive and 8.6% US-positive. PET and US measurements were correlated, albeit with poor concordance. The positive predictive value of PET/CT for clinical evaluation (tender and/or swollen) was low, whereas its negative predictive value was high. Highly significant differences were found with the number of PET/CT-positive joints and with cumulative SUV between "severe" and "non-severe" patients (including those in remission and those with low/moderate activity) and not between those classified as "remission" and "non-remission" or "remission" and "low/moderate activity". Moreover, the correlation between PET/CT measurements and clinical activity was positive only in the CDAI severe disease group. In patients in remission or with low/moderate activity, only 20-30% of joints were PET/CT-negative. In remission, PET/CT and US were positive in different joints, and PET/CT-positive but US-negative joints mainly exhibited RA (38.1%) or normal (49.2%) and not osteoarthritic (12.7%) X-ray patterns. CONCLUSIONS: [(18)F] FDG PET/CT was effective at distinguishing patients with severely active disease from other patients. In non-severe RA patients, including those in remission, PET/CT results are discordant from US and clinical observations. A longitudinal analysis is needed to explore the clinical relevance of such infra-clinical disease.
Disciplines :
Rheumatology
Author, co-author :
Rinkin, Charline;  Centre Hospitalier Universitaire de Liège - CHU > Rhumatologie
Fosse, Pacôme;  Centre Hospitalier Universitaire d'Angers - CHU ANGERS
MALAISE, Olivier ;  Centre Hospitalier Universitaire de Liège - CHU > Rhumatologie
Chapelier, Nathalie;  Centre Hospitalier Universitaire de Liège - CHU > Rhumatologie
Horrion, Jil;  Centre Hospitalier Universitaire de Liège - CHU > Radiologie
Seidel, Laurence  ;  Centre Hospitalier Universitaire de Liège - CHU > SIME > Biostatistique
Albert, Adelin  ;  Université de Liège - ULiège > Département des sciences de la santé publique > Département des sciences de la santé publique
Hustinx, Roland  ;  Université de Liège - ULiège > Département des sciences cliniques > Médecine nucléaire
Malaise, Michel ;  Université de Liège - ULiège > Département des sciences cliniques > Rhumatologie
Language :
English
Title :
Dissociation between 2-[(18)F]fluoro-2-deoxy-D-glucose positron emission computed tomography, ultrasound and clinical assessments in patients with non-severe rheumatoid arthritis, including remission.
Publication date :
2021
Journal title :
BMC Rheumatology
eISSN :
2520-1026
Publisher :
BMC, United Kingdom
Volume :
5
Issue :
1
Pages :
31
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
© 2021. The Author(s).
Available on ORBi :
since 20 December 2021

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